Recently, the Gastric Band Institute performed the first several single incision gastric band procedures in Las Vegas.The procedure differs from the standard gastric band procedure in that instead of using 3-5 small incisions, a single larger incision is used to place the band.
Surgeons have been debating the merits of the single incision procedure for weight loss surgery and other surgeries like gallbladder surgery and appendectomy.However, the bottom line on single incision gastric band placement is that in selected lower BMI patients with smaller livers and thinner abdominal walls, it is a reasonable procedure with just a few more technical challenges than the standard 4-5 incision procedure.There does not appear to be any difference as far as pain or recovery between the two procedures, but which is cosmetically more appealing, 4-5 tiny incisions versus one larger more noticeable incision, is debatable.
We are pleased to be able to offer single incision gastric bands to some of our patients.Currently, technical equipment advances are being made that in the near future will increase the number of patients that can be offered this procedure.
A recent article in the NY Times reported a study citing that the incidence of kidney stones was twice as high in the obese population who had had gastric bypass than in the obese population who had not had weight loss surgery.Although not common, the incidence was about 8% after bypass compared to about 4%.
We have seen a few cases of kidney stones in our patients occur after gastric bypass, gastric band and gastric sleeve.Part of the increase incidence I believe is due to the fact that our post-op patients cannot drink water as fast or, “chug” it down, which may in part limit their fluid intake and be partly responsible for increased kidney stones.However, for many regular health reasons, we strongly encourage all our patients in the pre-op teaching classes to increase their water intake after surgery.If you have any questions about kidney stones that develop after weight loss surgery, please feel free to post them here.
Like I mentioned last Friday, we filmed a patient’s gastric band adjustment, or “fill” as we often call it, for those of you who want to see and understand how an adjustment is done.Below is a video of one of our patients, Ericka, with one of our physician assistants, Brian, undergoing a simple, five-minute fill.
We’ve also created a video of Brian demonstrating an adjustment on a model of a lap band and port for a more detailed explanation.If you have any more questions about gastric band adjustments, please post them here, or call the office at 702-384-8446.
Today we filmed a patient’s gastric band adjustment for those of you who have never seen an adjustment done and want to know how it works. You will soon be able to check it out here and at our YouTube channel: www.youtube.com/user/LVGBIpatients. Stay tuned!
Have you seen the infomercial for the weight loss product Lipozyme?“Clinically proven at a major university” to help patients lose weight is their claim.Like ALL nonsurgical weight loss commercials there is tiny fine print on the screen.Usually it says “weight loss not typical” or “your individual results may vary” like it does for Nutrisystem, Jenny Craig, Weight Watchers, and Dexatrim.
The Lipozyme ad says in fine print that the average weight loss was about 3 lbs.So, if your BMI is 40, or about 100lbs overweight, the average patient could lose about 3% of their excess body weight, hardly enough to have a dramatic improvement in health.After weight loss surgery, the average patient loses 50-75% of their excess body weight and the exceptional patient loses it all.If you are considering these types of products, remember to ALWAYS read the fine print.
If you have any experiences with using Lipozyme, or similar weight loss products, please feel free to share them with us.
Some of our patients have done impressive things like running marathons and jumping out of airplanes.One of our patients, Mr. Keith Bettinger, who has lost 75 lbs. since his surgery about 4-5 months ago, has written a light hearted book titled “Fighting Crime With ‘Some’ Day and Lenny.”I recently enjoyed reading this compilation of Keith’s humorous short stories which draw upon his experiences as a Suffolk County, New York police officer. Now retired from police work and living in Las Vegas, Keith has won awards for his short story writing skills. Personally knowing Keith has made reading his work so much more interesting because I can see in his writing the same wit, humor, and sarcasm he brings with him on his office visits.If you’d like a copy of the book, please contact Keith at keithbett@cox.net.
“Clean your plate!”We all grew up hearing it, and I think this phrase is largely responsible for our growing obesity problem.We should be teaching our children to eat until they are no longer hungry, then stop.If the alpha wolf or king lion ate until all the food was gone, the pups and cubs would starve.But as humans we have conquered our environment so these laws of nature no longer apply and we now clean our plates so all the food is gone.
Part of the lifestyle change required for our patients to be successful is to eliminate those thoughts we learned during our upbringing that make us feel guilty or wasteful if we leave any food on our plates.By limiting food intake, patients that have undergone weight loss surgery realize that it is OK to leave food on their plate.Here at the Gastric Band Institute, our psychotherapist, Rachel, and our dietitian, Prudence, can also help with their Mindful Eating classes.For more information on when these classes are taught, please call 702-384-8446.
Please share here the infamous lines and techniques your parents used to coax you to eat.I bet this sounds familiar: “Just three more bites!”
Because the Gastric Band Institute has overseen the surgical weight loss of several thousand patients to date, I’ve been able to observe unique patterns common to very successful patients as well as those patterns common to less successful patients.This information may be helpful to potential patients trying to decide if a surgical weight loss procedure is right for them.
Patients struggling with their weight loss tend to look at their gastric band as something which should physically stop them from eating that one extra bite.They tend to “challenge” their operation, sometimes almost to prove that they can eat past their latest adjustment. As a result, they get food stuck more frequently and tend to have their bands tighter and have more problems with reflux.
The successful patients tend to look at their band as a tool which helps them stop themselves from eating more than is necessary to satisfy their hunger.They stop well before the last bite, they have more “eating margin” as described in a previous blog, have less reflux and don’t need to have their bands adjusted as tight.If you have questions about how to utilize the band for weight loss properly, please leave me a comment and I will reply, or contact Brian or Melissa, our physician assistants, at 702-384-8446.Also, if you have any advice or testimonials of how eating with the band correctly has made your weight loss successful, please tell us about it.
A common question potential patients have is “How much loose skin will I have after I lose weight?”Most consider some loose skin a good trade-off for better health and a lower body mass index (BMI).How much loose skin a patient will have depends on several variables:
Age.Younger patients have a higher percentage of collagen in their skin and tend to have less loose skin after weight loss than older patients.
Fat distribution.Patients whose fat areas are evenly distributed tend not to have one problem area.Those who have a larger percentage of their fat stored in one area may be more likely to have a problem in that area.
Rate of weight loss.Band patients, who typically lose weight at a slower pace than bypass patients, may have an advantage in this area, especially if they exercise during the process.
Amount of weight lost.For most of our patients with a BMI within the range of 35-50 lose about 60-120 lbs., loose skin is not a major problem. For those who lose much more than this it may become an issue.
Lasers and fat dissolving clinics are gimmicks and work very poorly for this.Although only about 5% of our patients are bothered enough by their loose skin to have plastic surgery to remove it, surgical excision is still the best option.If the plastic surgeon you choose is not familiar with how to handle the band port during a tummy tuck, they will usually call me, Dr. Atkinson, or Brian, our Physician Assistant and Program Director, before the procedure to discuss this. Because our program is the most successful surgical weight loss program in Las Vegas, some of the local plastic surgeons have created special discounted rates exclusively for our patients.We also have some Las Vegas plastic surgeons periodically give seminars to our patients to educate them on their options.Contact Denise, our Practice Manager, at 702-384-8446, for more info on this topic.
The U.S Agency of Healthcare Research and Quality recently reported a 21% decline in obesity surgery related complications between 2001 and 2006.This was despite the fact that more older and more sick patients were electing to have surgery compared to previous years.Insurance companies also paid less to hospitals, 13%, because of the decrease in the number of complications.Hopefully, this report will lead to more insurance companies offering obesity surgery as a benefit for their patients and increasing the access of patients to these life-changing procedures.
The reasons for the decrease in complications were:
increased use of laparoscopy and minimally invasive surgical techniques
